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PERMIT APPLICATION <br />�„ CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201, 425-257-8810 <br />SITE ADDRESS <br />sA.o� ��� ��� �. ��; <br />LEGAL LOT NO. BLOCK <br />DESC. <br />OWNER <br />TfL�1NSWRll1 L��-�TrLIL <br />TENANTNAME <br />�Ra�,u,� CI�-,z« <br />CONTRACTOR <br />E��S�;-E tl�T � kC. <br />PHON 4�) 252-3�1 <br />PROPOSED USE OF BUILDINO <br />PERMIT <br />Trve <br />CONTRACT PRICE OF WORK <br />WORK DESCRIPTION <br />1�s��� (2) If U A C <br />NO. I TYPE OF FlXTURE OR ITEM <br />��� 1�85,°� <br />PARCEL TAX I.D. N <br />3�+00 34nr �uc- lV� <br />!'ONTACT NAME <br />C�+ah �-ta.�,�s �., <br />ADDRESS <br />Ibll C-, ttitdtiv..� �'l�v �l. <br />�Ue¢�Ti , �..l.t qt2u � <br />PERMIT N <br />,�o <<a— �� <br />PHONE <br />PHONE <br />(42S) �7G —�9�8 <br />CONTR. LICENSE N <br />EVEQGSSG2ZG"[' <br />BBullding jD�Mechanical Additlon HEAT SOURCE <br />Combinelion D Plumbing WORK R_Alteretlon D Eiectdc <br />gDemolition D Sign TYPE ej New C�'oag <br />Sprinkler � qepelr/Maint. U Othar <br />CITY OF EVERETT LOCAL SALES TAl( CODE IS 310.5 <br />Sy�s��5 F�,t Nt� opt-c� <br />WATER CLOSET <br />BATHTUB <br />LAVATORY (WASH BASIN) <br />SHOWER <br />KITCHEN SINK 8 DISPOSAL <br />DISHWASHER <br />LAUNDRY TRAY <br />CLOTHES WASHER <br />URINAL <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />BACKFLOW PREVENTER <br />SINK (SERVICE/BAR/MOP/ETC.) <br />N0. I TYPE OF FlXTURE OR REM <br />A/C - A/HANDLIN� UNITS <br />FORCED AIR SYSTEI:IS <br />HEAT PUMP <br />UNIT HEATERS <br />CLOTHES DRYER <br />RAN6E H000 , <br />\VATER HEATER <br />� tEFAL FIREPLACE/STOVE <br />F IREPLACE INSERT ' <br />G AS FIREPLACE '''� <br />GAS RANGE <br />OAS PIPING <br />EXHAUSTFAN <br />OTHER <br />I H�AEBY CERITIFY THAT I HAVE READ AND EX' 11NED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALl <br />� 'ISIONS OF LAWS AND ORIDINACES GOVERNINO THIS TYPE OF WORK WILI BE COMPIIED WITH NJHETHER SPECIFIED HEREIN OR <br />' THE GRANTING OF A PEFMIT DOES NOT PPESIIME TO QIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISION OF ANY OTHER <br />��. OR LOCAL LAW REGUTATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION, THAT I AM AUTHOFIZED BY THE <br />]� , cR OF THIS PROPERN TO PERFORM THE WORK FOR WHICH APPLICATION IS MADE AND I.COMPLY WITH THE STATE <br />�'� �, i fFAC70PS LAW iB,27 RCW AND 296,200 WAC. <br />/�/ /�/o/ � <br />